Protecting children, supporting professionals
Archive for the ‘External Article’ Category.
PACA supports whistle blower paediatrician Dr Kim Holt.
If those of you who follow the link to Andrew Gilligan’s blog want to know more, perhaps you could read the NHSL (National Health Service for London) report on this matter at this link:
PACA has been supporting a Consultant Paediatrician who worked in Haringey before Baby P died.
This is a link to an article on the Sunday Telegraph website:
http://www.telegraph.co.uk/news/uknews/baby-p/6739202/If-Great-Ormond-Street-had-listened-to-me-Baby-Peter-would-still-be-alive-says-consultant.html
On reading this article PACA has released the following press statement:
6/12/2009
STATEMENT BY PACA: DR KIM HOLT SHOULD BE THANKED AND REINSTATED
For immediate release:
PACA (Professionals Against Child Abuse) wishes to express its support for Dr Kim Holt, Consultant Paediatrician, following the publication of information about concerns she and others raised in 2006 about the management of children’s health services in Haringey.[1]
Dr. Holt was one of four Consultant Paediatricians who wrote to their managers listing numerous concerns which they had raised for at least two years at that stage.[2] Many of these were the same as factors identified by the Care Quality Commission when it reviewed the death of Baby P.[3] Only one of the four Consultants is currently in post.
PACA notes with concern the fact that Dr Holt has been excluded from her job for over two years, is currently on a temporary secondment, with no long term job security and that she has always been clear that she wanted to return to her original post. PACA notes that Dr. Holt stated that considerable efforts were made to have her removed.
It appears that Dr. Holt is yet another NHS whistleblower who has been badly treated by the NHS after raising legitimate concerns. This is unacceptable. Following the Stafford scandal, health ministers repeatedly stated that whistleblowers enjoy full legal protection from the Public Interest Disclosure Act 1998.4 If this were truly the case, Dr. Holt would not have suffered these detriments. We would welcome a statement from a minister on this matter now.
PACA suggests that Dr. Holt should be thanked by her employer, Great Ormond Street Hospital for Children NHS Trust, which should also offer her a public apology. It should reinstate her and supply the necessary resources to allow her to do her job. It should also compensate her for the unnecessary costs she has incurred, including those relating to unnecessary legal costs and maintaining her skills whilst excluded from the workplace. We do not see that any other course of action is in the interests of vulnerable children, the wider community, and the NHS.
We note that Great Ormond Street’s spokesperson finds it “difficult to comment until an independent investigation is completed.” We understand that the report from the investigation was supposed to have been published in September 2009. Ongoing delay appears to prevent Great Ormond Street from addressing important issues. We believe that it is in the public interest for that report to be published. When it is, PACA members will study the report to see what implications it may have for other individuals involved.
John Bridson Chair PACA
—
Notes
1 BMA News Review, front page headline, 21 November 2009; Sunday Telegraph, 6 December 2009.
2 A. Gilligan, Doctors raised alarm over ‘high risk’ at Baby P clinic, Evening Standard 12th May 2009
3 CQC, Review of the involvement and action taken by health bodies in relation to the case of Baby P, 2009 [Draws on previous independent investigation] http://www.cqc.org.uk/_db/_documents/Baby_P.pdf
4 See, for example, Ben Bradshaw MP, Minister of State for Health, House of Commons Hansard 18 May 2009.col 1227W.
Information about PACA: Children are the most vulnerable members of society. Sometimes the very people who are expected to protect them place them at risk. It is then that professionals who work with children have a duty to protect them. PACA believes that vulnerable children need dedicated paediatricians, nurses, social workers, teachers and the law to protect them. PACA was formed in response to high profile cases against paediatricians at the General Medical Council at which it became clear that the present regulatory systems did not protect children and were open to abuse by those who sought to discredit professionals who stood up publicly for children’s rights. PACA advocates for children’s rights by campaigning for regulatory organisations to be trained in child protection, for the interests of the child to be paramount, and for professionals who stand up for children to receive fair treatment.
The Law Commission Consultation Paper on Expert Witnesses contains some mythology. PACA member David Murray penned this excellent response.
We have learnt over the last few years that no one and no profession is infallible. Some people can see the myths, but others are blind to them and are led by their prejudices.
Link to the Law Commission Consultation Paper on Expert Witnesses (PDF)
Text of the response by David Murray:
“You invite comments on the Consultation Paper.
PACA, is a group of Consultant Paediatricians and doctors together with lawyers, social workers and psychologists involved directly in Child Protection, or indirectly in the defence of doctors maligned in the media and punished by the General Medical Council for acting for the abused child against the abusers. May we ask you to consider the points made in the attached letter? We would be delighted to offer advice on the medical and forensic implications of working in this difficult field where our duty to children now requires us to defend ourselves against unfounded and often malicious commentary.
The Paper itself uses inaccurate evidence to illustrate poor medical and scientific expertise. It would make more sense to have used as an example of misleading expert evidence, not the Clark case, but a case in which such evidence had been shown conclusively to be in error, and for that error to have lead directly and materially to an unjust conviction, rather than to pick a case where the finding of murder was based on convincing medical and forensic argument remote from the supposed failings of expert witnesses, and then use that imagined failing to claim that such events are a problem. There is no “dogma that holds that two or more unexplained infant deaths should lead inexorably to the conclusion that a murder has been committed”, nor do Meadow or any other paediatricians cleave to it as the commissioners hold. There is no evidence that, “multiple cot deaths in a family could have underlying genetic causes”, nor can it be reliably stated that the occurrence of a second cot death is “usually from natural causes” when all, some, or none of such cases might be murder. How are we to reach sound conclusions as to the merits of procedures designed to protect against misleading opinion when the examples used to adduce such a necessity are so flawed that they discredit the real experts and take their lessons from the opportunist incompetent?
Meadow is not an example of flawed expertise but an expert traduced for being too astute and prescient. It was he who first realised that his ally in the comforting and treating of the sick child, its mother, may be the agent of its distress. Is it not odd that the country’s most distinguished expert in the misfortunes and murder of children should be the focus of an inquiry into flawed medical expertise? Is it not ironic that the wrong target has been selected with the expert of great value to the Court confused with the inexpert ‘expert’ who makes clinically implausible suggestions of a cause of death that are just sufficient to persuade the Court that there is a real dilemma and that justice is best served by prevarication?
Those who deserve scrutiny are not the leading figures in paediatric and forensic medicine but those whose imaginative diagnoses serve their purpose in Court but would be lethally dangerous if made at the bedside of a critically ill child: the retired haematologist who thinks Victoria Climbié died of a rare disease that inflicted marks on her body that seemed, to all but him, the indentation of the bicycle chain used to beat her, the retired biochemist with the first ever case of a novel syndrome to explain a child dying full of salt, the microbiologist who added to a dead baby’s list of injuries, typical of violent suffocating assault, the clinically unsound diagnosis of an infection of such ferocity that it overwhelmed the child in its bouncy chair in no more than ten minutes, the doctor flown in to say that dreadful injuries could have been caused by epilepsy rather than brutal contact with a banister rail. Constructive advocacy acts in the interest of clients but seldom for truth or the protection of vulnerable children. A great injustice has been done to Sir Roy Meadow and to the murdered children and should not be added to.”
The BMA has released a child protection tool kit for doctors.
From the site: The aim of this tool kit is to provide a brief and accessible guide to doctors’ responsibilities in child protection cases in England and Wales.
You can find out more here.
On the 1st of June, Panorama broadcast a programme entitled “A Very Dangerous Doctor”
This programme revealed the truth behind the Southall debacle.
Those of you who access this site might pass this link on to friends and colleagues.
http://www.bbc.co.uk/programmes/b00l6ds5
[Note: this programme can only be viewed from within the UK]
The Lancet expresses its view on the current situation in Child Protection, making an urgent suggestion: a UK Commission on Child Protection.
The outcome of the Southall appeal was astonishing. Read PACA’s letter published in the Lancet.
PACA has been drawing attention for a long time to the GMC’s lack of a vexatious complaints policy. Vexatious complaints have been a serious problem for Health Professionals trying to safeguard children. For this reason as well as sending, out this press release, three PACA members have written a paper for publication in the Archives of Diseases of Childhood on A Way To Restore British Paediatricians’ Engagement With Child Protection Arch. Dis. Child. 2009 : adc.2008.154997v1
Here is the link:
http://adc.bmj.com/cgi/rapidpdf/adc.2008.154997v1
External Article by Jonathan Gornall
[Article first published in The National]
Lawyers confer during the murder trial of a five-year-old French boy. Dennis Charlet
It was a tragically familiar story: a child tortured and battered to death by the adults who should have been caring for him.
What was different about the death of Marc, a five-year-old French boy whose short life ended in a blizzard of punches in Jan 2006, was that the doctors who failed to spot the serial abuse were held to account alongside the stepfather who delivered the blows.
Last week, a court in the French town of Douai sentenced eight people for their part in the death. David da Costa, 38, who punched Marc in the head until he suffered a cerebral hemorrhage, was jailed for life. Isabelle Gosselin, 35, the child’s mother, received 30 years; three other relatives and a childminder were given suspended sentences.
The postmortem revealed Marc had suffered a series of assaults and injuries, including cigarette burns, broken ribs and a fractured pelvis, but two doctors who saw the boy before his death accepted his mother’s explanation that he was self-harming. Christian Tirloy and Michel Vellemans were found guilty of failing to help a person in danger, fined and given three-year suspended prison sentences.
“These sentences are a warning to French society, professionals who work with children, the medical community and politicians to stop keeping silent and to understand the duty of reporting child abuse to the authorities,” said Catherine Bonnet, a French child psychiatrist who in the ’90s became the target of a group campaigning on behalf of accused parents.
In 1998, she was accused of making false allegations of child abuse against parents and banned from practising for three years.
“The pendulum has swung too far and professionals have been condemned for detecting, reporting and preventing child abuse.”
In 2002, Ms Bonnet’s case was taken up by the UN special rapporteur on child exploitation, who urged the French Medical Board to “review its procedures in order to support rather than condemn doctors who report their suspicions of child abuse”.
The French case has resonated among medical professionals in the UK, where for the past decade campaigners have been waging a media war against doctors who work in child protection. Paediatricians are also fighting a running battle with their regulatory body to defend their right to report suspected cases of abuse without fear of disciplinary action.
Dr John Bridson, the chairman of Professionals Against Child Abuse (Paca), founded in the UK last year to defend paediatricians, said the French trial was “symbolic of the lose-lose situation in which child-protection professionals find themselves, both in France, the UK and other countries”.
The case that led to the birth of Paca was that of Dr David Southall, a paediatrician and one of the UK’s most widely known child-protection experts, who has faced a record number of investigations by his regulatory body, the General Medical Council (GMC).
In 2004, he was found guilty of serious professional misconduct and banned from child-protection work after raising concerns about the safety of the surviving child of a woman who had been jailed for the murder of two of her three babies. Dr Southall’s suspicions were raised when, in a television interview, the woman’s husband described a nosebleed his 11-week-old son had suffered while alone with him just 10 days before his death.
Dr Southall, who had conducted research that indicated a relationship between nosebleeds in children of that age and suffocation attempts, contacted the police and the father complained to the GMC. In September, in a successful application to have the ban lifted, all five of the experts who gave evidence agreed Dr Southall had been right to report his concerns and that his research had subsequently been vindicated by other work.
Dr Southall’s long battle is not over yet. Last December, in a case that has caused further outrage among paediatricians, he was struck off the medical register on the say-so of a mother who claimed he had accused her of murder during a formal child-protection interview, conducted 10 years earlier.
The panel chose to believe the mother, despite evidence to the contrary from a senior social worker. Dr Southall is appealing.
In an open letter in the British Medical Journal to the president of the GMC, one doctor said the decision had left paediatricians “in an impossible position… The message your body has sent out is loud and clear: challenge parents at your peril, you will have no conceivable defence.”
But woe betide them if they do not challenge parents. Politicians and the media in the UK this week have been baying for professional blood following a court case on Wednesday in which two men were found guilty of “causing or allowing” the death of a 17-month-old boy. The child’s mother pleaded guilty.
“Baby P”, who was found dead in his bloody cot, had been on the child-protection register and was seen almost 60 times by various professionals. His mother had repeatedly deceived doctors and social workers, at one pointing smearing chocolate on the child to hide his bruises. A doctor who saw Baby P two days before his death failed to notice his broken spine.
Dr Southall, speaking from the Gambia, where he is on assignment for the British medical charity Childhealth Advocacy International, said: “This is at the heart of it; despite all the evidence to the contrary that has been gathered over the years, no one – including the media, politicians and the general public – is prepared to believe child abuse happens as frequently as it does, until it is too late.”
